前颅窝底粉碎性骨折一期颅底重建的临床体会  

Reconstruction of anterior cranial base with traumatic comminuted fractures

作　　者：王举磊[1] 秦怀洲[1] 张治国[1] 高国栋[1] 马廉亭[2] 

机构地区：[1]第四军医大学唐都医院神经外科,西安710038 [2]广州军区武汉总医院神经外科,武汉430070

出　　处：《中国临床神经外科杂志》2012年第7期385-387,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨创伤性前颅窝底粉碎性骨折的手术技巧及效果。方法回顾性分析51例前颅窝底骨折患者的临床资料。每个病例术中均进行一期骨性重建及膜性重建,其中39例使用钛网为修补材料,12例使用自身颞骨修补,术后定期随访,并行CT检查。结果术后随访3至12个月,1例死亡;1例术后2周复发脑脊液漏,经腰大池置管引流2周后消失;1例颅内感染;1例眶颅穿通伤患者术后2个月出现眶内感染,经治疗后痊愈。其余47例恢复良好,均未出现脑脊液漏、脑膜膨出等并发症。结论良好的骨性重建及膜性重建可有效防治前颅窝底骨折后引起的脑脊液漏及脑膜膨出,膜性重建更为重要。Objective To explore surgical technique to treat the traumatic comminuted fracture of anterior cranial base and the curative effect on it.Methods The clinical data of 51 patients with traumatic comminuted fractures of the anterior cranial bases who underwent one-stage reconstruction of skull base including dura and cranial bone defect repairs were analyzed retrospectively.Titanium net was used in 39 patients and autologous temporal bone was used in 12 patients to repair the bony defect.Results Of 51 patients followed-up from 3 to 12 months,47 were recovered well without the complications,1 had cerebrospinal fluid leak and was cured by lumbar cistern drainages,2 had intracranial infection and were cured by antiinfective treatment and 1 died.Conclusions Skull base reconstruction including the dura and cranial bone repairs can improve the prognosis in the patients with traumatic basicranial comminuted fractures in whom reconstruction of the dura was more important to prevention of cerebrospinal fluid leak than the bone reconstruction.

关 键 词：颅脑损伤 前颅窝底骨折 颅底重建 膜性重建 脑脊液漏 

分 类 号：R651.15[医药卫生—外科学] R651.11[医药卫生—临床医学]